[Reoperative thyroid surgery: personal experience and review of the literature].
The goal of this study was to evaluate the complication rate of reoperative thyroid surgery and to find out the way to minimize the morbidity associated with it. We reviewed our experience in 622 patients, who underwent thyroid operation from January 2000 to September 2007. Among these ones, 76 were the patients who underwent reoperative thyroid surgery. Prior surgery in the 76 reoperations was: nucleo-resection in 9 pts (12.9%), lobectomy in 43 pts (55.5%), lobectomy+isthmectomy in 7 pts (9.3%), subtotal thyroidectomy in 17 pts (22.2%). Histologic examination revealed: benign lesions in 67 pts (88.15%), papillary cancer in 4 pts (5.26%), follicular cancer in 2 pts (2.63%), follicular adenoma in 1 pt (1.32%) and Hashimoto thyroiditis in 2 pts (2.63%). Complications included: section of recurrent laryngeal nerve, that was reconstructed in the same operation, and bilateral palsy of the recurrent laryngeal nerve so that was necessary to make a tracheotomy. One of the patient at the first thyroid surgery had monolateral palsy of the recurrent laryngeal nerve with dyspnoea and dysphonia. Temporary hypoparathyroidism (Ca<8 mg/dl) occurred in 47.3% of the patients, who underwent reoperative thyroid surgery and in 45.2% of the patients, who underwent prior thyroid surgery. Conclusions. This study documents that reoperative thyroid surgery can be performed with little morbidity to the patient if precise operative rules are respected.
Pironi
D
D
Università degli Studi di Roma La Sapienza, Policlinico Umberto I, Dipartimento di Scienze Chirurgiche, U.O.C. Chirurgia General ed Endocrina, Rome.
Panarese
A
A
Candioli
S
S
Manigrasso
A
A
La Gioia
G
G
Romani
A M
AM
Arcieri
S
S
Mele
R
R
Filippini
A
A
D018263:Adenocarcinoma, Follicular / Q000601:surgery; D000236:Adenoma / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D050031:Hashimoto Disease / Q000601:surgery; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology; D061224:Laryngeal Nerve Injuries; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult